Fillable bossier parish communit~ college iscal Year: 2019-2020 (Bossier Parish Community College)

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bossier parish communit~ college iscal Year: 2019-2020 (Bossier Parish Community College)

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Date: F
iscal Year: 2019-2020
bossier
parish
communit~ college
___________
Name: ________________________________ Phone extension: _____________
Department: ___________________________ ___________ B
irthday (MM/DD):
$1
5.00 dues (Please check payment type)
______Cash
______Check (payable to BPCC Staff Senate) Check number ________
______PayPal (please send using the Friends & Family option)
Receipt#_____________________
Pl
ease send dues to: Karen Ward, Staff Senate Treasurer
Workforce Development & Continuing Education
Building D Office 153
318-678-6368
kward@bpcc.edu
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Completed 17 September 2020

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